Author’s Note: “In grade school, I remember encountering Robert Frost’s ‘The Road Not Taken’ and leaving with the false impression—encouraged by well-meaning teachers—that the poet was exhorting his readers to follow the road ‘less traveled by.’ In hindsight, while this reading of the poem is rather simplistic, I have continued to find myself fascinated by paths never traveled, alternative realities that deviate slightly (or greatly) from my own, and the increasing recognition with age that much of life is shaped by roads not taken and doors closed by choice or circumstance. My parents deserve credit for opening doors for me, but also for closing them, as this essay reveals….”
IN KINDERGARTEN, FIRST GRADE, SECOND GRADE, infinite futures opened before us like the automatic doors at the Pathmark—some leading to fire stations or ballet stages, others as far as the moon—and then suddenly in third grade, at Miss Spillman’s command, we found ourselves forced to choose. Our teacher’s decree arrived in the form of a dittoed handout, purple ink still pungent with methanol from the duplicator, instructing us to decide upon a career and depict this vocation on an oak tag poster. Alas, I was not one of those striving nine-year-olds endowed with detailed fantasies of becoming a big game veterinarian, or a Ringling Brothers clown, or of replacing Bucky Dent at shortstop for the New York Yankees. Any musical ambitions I might have nurtured had been dashed earlier that autumn when my parents arranged a “bedtime talk”—a formal affair—to reveal that Mrs. B., the Swiss taskmaster responsible for my weekly piano lessons, had abruptly carted up her instrument and relocated out-of-state. Around that time, as I recall, having stumbled upon a historical atlas, I’d voiced an interest in cartography, only to be met with disdain: the eldest sons of nephrologists in bedroom suburbs might reach for the stars but not chart the earth.
Of this point only was I certain: I did not wish to become a doctor. My father, who was a prominent kidney specialist, had ensured my resistance during a hospital visit in the late 1970s: We’d gone together one weekend afternoon to check up on his dialysis patient and, while he demonstrated the “lost art” of physical examination, a faulty catheter in her groin led to geysers of blood. This was before AIDS, largely pre-PPE. I remember being ordered to a corner, stunned and in terror, until the unfortunate woman could be stabilized. Yet only a portion of the responsibility for my negative impression of medicine belonged to my father’s crimson-splattered glasses. Stories handed down from my grandfather, a one-time military psychiatrist, deserve a share of blame: how he’d treated servicemen who’d butchered their own commanding officers, how he’d later performed electro-shock therapy in his home office on a table also used for family dinners. The Lord’s work, maybe, but not exactly Marcus Welby, MD.
So that was my poster: “NOT A DOCTOR.” Sensing that my parents might not approve, I conducted my drawing clandestinely in my bedroom. Today, I might have depicted maniacal surgeons, eyes and bone saws equally agleam, or possibly medical atrocities like Tuskegee and Willowbrook. At nine, my approach was to depict doctors in action, stethoscopes dangling, white coats crisp, as though I did intend a Hippocratic adulthood—and then to slice through my creation with the red circle and backslash of universal prohibition. In the end, my poster proved as clear and decisive a rejection of the medical arts as could be hoped for, and no grade school Picasso has ever been so proud, or rightly so, smuggling his masterpiece to school in a cardboard tube.
Miss Spillman, to her credit, didn’t fail me outright. She was one of those old-style elementary school educators who carried with her an aura of perpetual amusement, and her teaching style, while not exactly Socratic, involved asking naïve questions: What kind of training did one require to ‘not become’ a doctor? Did a person need a license? A uniform? She pressed her broad flat palms together in front of her lips, as though deep in reflection, and it was almost as though she were winking without moving her eyelids. And what, she asked, would I do with all my free time while I was not being a doctor? In the end, I agreed to craft a second poster.
I believe this magnum opus remains preserved in my parents’ attic, awaiting discovery by twenty-second-century critics. Or possibly termites. I fear that upon this one masterwork hangs my hope for posthumous artistic glory. Its theme: “NOT A PSYCHIATRIST.”
READER, I BECAME ONE. Despite my most valiant efforts— and even a detour through law school—I now earn my keep as a headshrinker, a trick cyclist, a couch quack. What the Germans call a Seelenklempner or “soul plumber,” and my mother, for whom I remain her son-who-is-not-the-rabbi, terms “almost a real doctor.” Whether as a result of predestination or Brownian motion or free will, I stumbled through the gates of Aesculapius and never looked back. In contrast, I am not a pianist. By not a pianist, I don’t mean not a rival to Vladimir Horowitz and Arthur Rubenstein, nor even Victor Borge, but rather three-thumbed and tin-eared, no longer capable of playing “Jingle Bells” or “Frère Jacques” with the sheet music. Mrs. B.’s mad dash for the state line had managed to block permanently my path to Carnegie Hall. My own floundering efforts merely obstructed temporarily the asylum entrance without managing to padlock its gates.
Closing doors is no easy business. Even edging them shut a few inches can be challenging for many contemporary Americans, especially those of the middle and upper classes, trained from childhood to keep their options open and to reach for the moon. Our ambitions may be Caesarean, but the underlying mantra is pure Cassius: if we do not achieve stardom, the fault lies in ourselves for failing to preserve our opportunities. Alas, these goals—more choices, higher aspirations—are often incompatible: With a few rare exceptions, maybe Leonardo da Vinci or Benjamin Franklin, success comes from specialization—from targeting relatively narrow but worthwhile objectives and pursuing them relentlessly. Usain Bolt may try his legs at the 100-meter sprint and the 400-meter dash, but he doesn’t also pursue medals in archery and curling. To master the clarinet, Benny Goodman had to forgo the French horn and the sitar, as well as training in astrophysics and architecture. For all Emma Goldman’s talk of dancing after the revolution, she kept her nose on the anarchist grindstone and left Fred Astaire to Ginger Rogers.
In fact, closing doors is essential to well-adjusted living. Pursuing a career in law or medicine generally means waiving the other, and failure to do so risks the fate of Richard Carstone in Dickens’s Bleak House, who trains in both professions, yet is able to practice neither. When a bride and groom stand before the altar and declare, “I do,” they are presumably also proclaiming, “I don’t,” to countless other former passions and prospective suitors. Love itself is the supreme act of door slamming. Of course, we all know lotharios who adopt the collect-them-all approach to romance, like ice cream aficionados taste-testing all thirty-one flavors at Baskin Robbins, but at some juncture, failure to commit becomes self-defeating. Basketball legend Wilt Chamberlain, who died unwed and childless after a record-setting course of regretted promiscuity, serves—by his own admission— as people’s exhibits one through 20,000.
When medical students approach me for career advice, which is a staple of my work in academic psychiatry, I generally avoid discussing Wilt the Stilt’s sex life. In any case, I suspect many would not recognize his name, and a few might even mistake him for Winston Churchill’s predecessor on Downing Street. (To anyone doubting that fame is fleeting: I’ve already encountered students who believed Lou Gehrig’s disease took its eponym from a neurologist.) But these young men and women— in their own modest way—are fighting to win a version of the battle that Wilt lost 20,000 times. They have discovered that becoming a transplant surgeon means not becoming a pediatrician, and that becoming a pediatrician means losing the opportunity to procure livers and implant kidneys, and for some, still struggling to fit into their psychological white coats, that embracing either may preclude writing plays for the stage.
Helping this last group is often the most difficult. Medical education, an in-for-a-penny, in-for-a-pound enterprise to the tune of many years and hundreds of thousands of dollars, does not make second-guessing easy. How does one advise a student to jump off the Hippocratic conveyor belt? And when? Should they complete their degrees? Finish their internships to acquire licenses and prescription pads? Stick it out long enough to pay off their loans? These questions are all the harder when approached with a mindset that equates closing doors with failure. Among the many words of wisdom attributed to deaf- blind activist Helen Keller, mostly false, she apparently did write: “Often we look so long at the closed door that we do not see the one that has been opened for us.” This is the fate of Lot’s wife on the plain of Jordan, of Miss Havisham in the darkness of Satis House. I can echo this sentiment firsthand: I hardly ever encounter a piano, whether in an upscale parlor or a cocktail lounge, without thinking of Mrs. B. and her distant betrayal.
THE MEDICAL STUDENTS often ask how I became a doctor. I rarely mention my contribution to Miss Spillman’s occupational gallery, the row of tagboard sketches that hung like laundry across the back of her classroom for much of that winter. One of my classmates, in my memory, aspired to rescue elephants from poachers. Another planned to become the next Michael Jackson. (I wish I could attach a name to these remote dreams—to track down my erstwhile classmates to assess their prognostic skills, or just for a good laugh—but you don’t have to be a psychiatrist to realize that surveying your former third-grade classmates on their dreams derailed is a sign of an incipient midlife crisis, or at least far too much time on your hands.) I see no upside in relating to the students Miss Spillman’s response to my second poster: how she stood, arms akimbo, as though at the unveiling of the Mona Lisa or Washington Crossing the Delaware, and then served up a silent nod that I took for approval, but likely represented calculated resignation.
What I do tell the medical students about is Robert Frost. Particularly, Robert Frost’s celebrated poem, “The Road Not Taken,” which Miss Spillman recited to generations of grammar school students as a paean to individualism. We had read the poem previously as second graders in Mr. Minard’s class, alongside standards by e. e. cummings and Emily Dickinson, there being considerable curricular overlap in the era before relentless standardized testing, but for Bob Minard, the poem had been about roads. I vaguely recollect an exercise that involved drawing hobos carrying bindles. For Ruth Spillman, Frost’s verse was all metaphor: “Two roads diverged in a wood,” and by choosing “the one less traveled by,” we might someday become the next Edison or Einstein or Earhart. She was a lovely woman, Ruth Spillman. Hopeful, encouraging, and authentic. (Decades later, I sent her copies of my early novels, and following her death, her partner approached me at a public lecture to thank me.) I still have no idea whether she misrepresented Frost’s lines intentionally or had absolutely no idea what they were about.
The poem serves as an ideal mirror for the questioning medical student. Frost’s point—as elucidated in David Orr’s well-known Paris Review essay, “The Most Misread Poem in America”—may be that both roads hold equal promise. Only in hindsight does the road we choose, for better or worse, make “all the difference.” According to an alternate reading considered by Orr, “the poem isn’t a salute to can-do individualism; it’s a commentary on the self-deception we practice when constructing the story of our own lives.” When I broach the century-old stanzas with future doctors, my goal is for them to recognize their good fortune: Many of the roads before them lead to auspicious futures. A contented pediatrician does not suffer nagging doubts about the transplants she never performed any more than a happily married husband reflects with regret on the countless women he never accompanied down the aisle.
Life does not offer one right answer, just multiple good ones. And poor ones too, of course: anesthesiology and obstetrics may both lead to distinct yet rewarding lives; murdering strangers on contract bodes less long-term joy. I used to recommend that uncertain medical students read Jonah Lehrer’s How We Decide (2009), which argues that some choices are best rendered on emotion and instinct. He suggests this gut check is a good method for buying a home. I also find this approach works well in choosing a medical specialty. Alas, the decision to recommend the book was taken away from me in 2013 when its author was accused of plagiarism and Houghton Mifflin Harcourt yanked the volume from bookstore shelves. Now I just tell the medical students to make a visceral decision and try not to second guess themselves.
Some doors are shut to us from the outset: several billion would-be heirs apparent, for instance, likely stand between my Ashkenazi-Jewish head and the English crown. Others close of their own accord. It is too late for me to win a Rhodes Scholarship or become a Navy SEAL—neither of which accept candidates in their forties—although the army did allow my grandfather to enroll in middle age after Pearl Harbor, so I suppose exceptions do remain possible. Even with daily lessons and first-rate coaching, I am no longer likely to sing Turandot at La Scala or play Bach’s “Goldberg Variations” to rival Glenn Gould. Yet most of my successes in life have resulted from paths that I have consciously shunned: rejected professions, third dates that didn’t follow seconds, essays that never met a printed page. Miss Spillman feared her students might lack the courage to open doors; my fear is that my own students won’t possess the confidence to close them.
Would Miss Spillman be pleased to see me a psychiatrist? Disappointed? I do not sell widgets for a living or ride a commuter train to Stepford, but I’m also not exactly the Wizard of Menlo Park nor will I be flying a biplane solo across the Atlantic anytime soon. I can’t help wondering if there is a parallel universe where Mrs. B. never moves away, and I grow up to become not-a-psychiatrist, licensed and uniformed, and Miss Spillman spends her final days listening to my classical piano recordings. He took the road less traveled, she tells her partner. Like in the poem. Shame on me for thinking he’d give in and end up shrinking heads….
I DIDN’T FULLY UNDERSTAND how I’d become a psychiatrist until several years after completing my residency. We’d gathered for a Thanksgiving dinner at my boyhood home. Upon entering, one immediately encountered a cased archway leading to a low-slung sitting room that remained frozen in the final days of the Carter administration: tight plaid upholstery in earth tones, hard-backed copies of American Heritage and Horizon shelved on rosewood. The piano, too, stood precisely where I’d left it decades earlier, a console model, although now it served primarily as an oversized plinth for family portraits and greeting cards. Someone, most likely my aunt, had deposited her coat and purse atop the bench. I doubt anyone had played the instrument since the evening before my final lesson unless one counted contests my preteen nephews had to gauge who could bang its keys the loudest. You’ll find similar relics all across the suburban landscape, untuned testaments to the aspirations of men and women whose parents had escaped Pinsk or Palermo—and later fled integrated blocks in Morrisania or Brownsville. For couples like my parents, what mattered was owning the instrument, not playing it. On the remote chance you wanted to listen to a Grieg concerto, or “Stairway to Heaven,” you turned on the radio.
In the weeks leading up to the holiday, I’d been contemplating tracking down Mrs. B. As a psychiatrist, I find myself attributing the behavior of others, and my own, to the ordeals of early childhood, and—for whatever inexplicable reasons—the abrupt end to those weekly musical forays loomed large in the rehashing of my personal history. Or maybe my interest was mere self-deception, a twist on Professor Orr’s reading of Frost. If those who chose a less traveled road of their own creation could take credit, why shouldn’t others (like me) who had opted for the opposite fork—at least in hindsight— castigate themselves? Why hadn’t I argued for a new piano teacher rather than accepting Mrs. B’s departure as decisive? Somehow reconnecting with my Swiss piano instructor seemed essential for closure. Assuming she were even still alive. Ruth Spillman had passed away the previous June in her mid-eighties, but I’d only learned of her death that autumn, adding to the urgency of my quest. In my memory, Mrs. B. had been as ancient as music itself, although in hindsight, she’d probably been younger than I am now.
The challenge was that I didn’t know Mrs. B.’s first name, nor even the precise spelling of her surname, so my only hope was to recruit my parents into my efforts. I did this gingerly— with some trepidation. My parents are not ones to dredge the past, and earlier attempts to track down the previous owners of their home and to locate long-lost relatives of my grandmother had both been met with indifference. Sometimes people drift apart for a reason, my dad had said of the abortive hunt for Grandma’s second cousins. Why spend your time on that? Think of all the people you could be helping instead . . . .So I waited until a post- prandial lull in the conversation, hoping pumpkin pie and apple cider might help them swallow my question.
“Do you remember Mrs. B.?” I asked. “My piano teacher….”
My father glanced up blankly from his dessert. “Did you take piano lessons?”
“With that Swiss woman,” replied my mother.
“For three years,” I emphasized. “Do you remember her first name?”
My mother shook her head. “I don’t think I ever knew it….”
Then she ducked into the kitchen to retrieve fresh coffee for our guests and the conversation drifted back to vacation plans, gardening, whether my aunt might retire. Case closed. Had the meal lasted until the Pilgrims returned to Plymouth Rock, nobody would have inquired why I’d suddenly sought the name of a piano tutor not mentioned for nearly four decades.
I tried a different tack. “I’m thinking of tracking her down,” I said. “Mrs. B. To ask her why she moved away so abruptly….” My mother had returned with more coffee cups than she could safely carry. She’d taken piano lessons as a child herself, I knew—so maybe she could empathize. We still kept her old metronome and several of her method books. Had she laughed off my questions, I’d have taken her lack of interest in stride; to my surprise, she responded with silence. I could see her trying to draw the attention of my father, who was busy regaling my date with a joke.
“Maybe I can find her without a first name,” I pressed. “You don’t happen to remember where she moved to….”
“She didn’t move anywhere,” said my mother.
“Yes, she did,” I insisted.
“No, she didn’t. We just told you that.”
A hush had descended upon the table, as though my extended family had sensed the relative unimportance of their own conversations; even my dad had resisted another joke. Suddenly, my mother found herself with an audience. “We’re talking about his piano teacher….”
“I thought she moved away,” I said.
Now my mother smiled, as though recognizing a dose of unanticipated humor in the episode. “She called us and said you were one of the worst students she’d ever encountered—that you couldn’t hear when you made a mistake—and no amount of practice could fix that.” Even vicariously, after half a lifetime, the critique stung. I had practiced. Religiously. I’d curled my fingers precisely as she’d instructed and always sat up straight. “She said we were doing you a disservice,” Mom added, “by letting you continue. I can’t believe we never told you….”
“When would it have come up?” I asked.
Yes, when? Only on the literally thousands of occasions I’d had dinner with my parents between the ages of nine and forty- two. But the dark comedy wasn’t lost on me. If fate had steered me away from Carnegie Hall, it was on account of my own innate dearth of talent—not a-man-with-a-van who’d hauled off Mrs. B.’s piano. For all I knew, if she were still alive, she might be residing at the very same address, even giving lessons on the same baby grand piano. That interested me much less. What was I going to do? Knock on her suburban door and ask: Remember me? Your worst student ever?
So that was that. I suppose my musical career would have ended anyway, sooner rather than later, but somehow Mrs. B.’s rejection towered over my future choices like a Mount Rushmore of Mozart and Beethoven and Brahms. She had closed the doors of virtuosity, driving me along the well-worn path that led to medicine and then head-shrinking. How could anyone have been so heartless? I asked myself. And what could I possibly do to thank her? I forced a smile, trying to brush off the shock. “Glad we’ve cleared up that mystery.”
Only there had never been any mystery. Only the echo of doors: closing and opening, opening and closing. Maybe a pair of tin ears had kept me from hearing the din.
My mother laughed. “We’re just not a musical family,” she said.
Jacob M. Appel is a physician, bioethicist, American author, lawyer, and social critic in New York City. He is the author of twenty volumes of fiction and nonfiction, and most recently the novel “Shaving with Occam.” He is also known for his short stories, his work as a playwright, and his writing in the fields of reproductive ethics, organ donation, neuroethics, and euthanasia. Website: www.jacobmappel.com
Delmarva Review is a nonprofit, independent literary journal that selects the most compelling nonfiction, fiction, and poetry from thousands of unpublished, new submissions during the year. Designed to encourage outstanding writing from authors everywhere. Support comes from tax-deductible contributions and a grant from Talbot Arts with funds from the Maryland State Arts Council. Website: www.DelmarvaReview.org
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